509. Surgical Site Infections After Open Peripheral Revascularization
Session: Poster Abstract Session: Surgical Site Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • IDSA_poster_PV_Livorsi.pdf (131.2 kB)
  • Background: Surgical site infection (SSI) after open peripheral vascular surgery is a pervasive complication that may result in graft loss, limb loss, prolonged hospitalization, and increased cost.  This project sought to identify modifiable risk factors that predispose to SSIs after open peripheral vascular bypass operations.

    Methods: Between 10/1/2009 and 6/30/2012, the hospital’s Infection Prevention and Control Department performed surveillance for SSIs after open bypass operations on the peripheral arteries (ICD-9 code 39.29). All SSI cases were matched to 3 randomly-chosen controls, or non-infected patients, who underwent the same coded procedure.  National Healthcare Safety Network (NHSN) criteria were used to define all infections.  Co-morbidities included diabetes mellitus, chronic obstructive pulmonary disease, end-stage renal disease, cirrhosis, and infection with the human immunodeficiency virus.  Multivariable analysis was performed with logistic regression to identify factors predictive of SSI.

    Results: 254 procedures were performed during the surveillance period.  Twenty-eight infected cases and 84 controls were reviewed.  All patients were men, and the mean age was 63.7 years.  The infections met the following classifications:  5 organ/space infections, 4 deep incisional infections, and 19 superficial incisional infections.  Compared to controls, cases had a higher prevalence of medical comorbidities (68% vs. 40%, p=0.01) and higher body mass indices (31.0 vs. 27.6, p=0.01).  There was also a trend toward more frequent use of closed-suction drains (21% vs. 7%, p=0.07) and longer operative times (5 hr 19 min vs. 4 hr 34 min, p=0.05) in infected patients. The following factors were not associated with an increased risk for SSI: redo operation, a distal wound at the time of the operation, emergent surgery, femoral incision, or the use of a prosthetic graft.  On multivariable analysis, both operative time and having at least one medical comorbidity were predictive of SSI, OR (95% CI): 1.39 (1.05-1.86) and 3.39 (1.33-8.67), respectively.

    Conclusion: The duration of surgery and the presence of certain medical comorbidities were predictive of SSIs after open bypass operations on the peripheral arteries.  Certain factors such as obesity may contribute to the technical difficulty of the case and, in turn, prolong the operative time. 

    Daniel Livorsi, MD1,2, Paul Crisostomo, MD3, Mary Kinney2, Diana Greathouse2 and Michael Murphy, MD2,3, (1)Medicine, Indiana University School of Medicine, Indianapolis, IN, (2)Richard Roudebush VA Medical Center, Indianapolis, IN, (3)Surgery, Indiana University School of Medicine, Indianapolis, IN


    D. Livorsi, None

    P. Crisostomo, None

    M. Kinney, None

    D. Greathouse, None

    M. Murphy, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.